Screening for Alcohol Use in Criminal Justice Settings: An Exploratory Study

Aims: To examine the feasibility and acceptability of alcohol screening and delivery of brief interventions within criminal

justice settings. Methods: A quantitative survey of those aged 18 or over in English criminal justice settings (three custody

suites within police stations, three prisons and three probation offices). Measurements: The Fast Alcohol Screening Test (FAST)

and a modified version of the Single Alcohol Screening Question (M-SASQ) were compared with the Alcohol Use Disorders

Identification Test (AUDIT) as the ‘gold standard’. Participants completed a health status questionnaire (EQ5D), questions on

service utilization and the Readiness to Change Questionnaire. Questions relating to the acceptability and feasibility of delivering

brief interventions and about perception of coercion were included. Findings: Five hundred and ninety-two individuals were

approached and 251 were eligible. Of these, 205 (82%) consented to take part in the study. The mean AUDIT score was 19.9 (SD

13.5) and 73% scored 8 or more on AUDIT. A higher percentage of those approached in the probation setting consented to take part

(81%: prison 36%, police setting 10%). Those scoring AUDIT positive were more likely to be involved in violent offences (36.5 vs

9.4%; P < 0.001) and less likely to be involved in offences involving property (27.7 vs 45.3%; P = 0.03). Three quarters of the

sample (74%) reported that they would not feel coerced to engage in an intervention about their alcohol use. FAST and M-SASQ

had acceptable screening properties when compared with AUDIT with area under the curves of 0.97 and 0.92, respectively.

Conclusions: The results confirm that there is a major problem with alcohol use in the criminal justice system and this impacts on

health and criminal behaviour. Of the three criminal justice settings, probation was found to be the most suitable for screening.

Participants were positive about receiving interventions for their alcohol use in probation settings.